In life there are a number of important milestones, and for many families the first day of a child going to school is a milestone to remember — often with fondness, but for some, all too often, with pain.

How do parents know if a child is ready for school and do pediatricians have a role to play or is it exclusively the domain of principals, teachers and psychologists?

The American Academy of Pediatrics used their early childhood council and school health council to weigh in with a position statement about where pediatricians fit into the bigger scheme of things. A condensed summary reminds us all that early brain development matters a great deal and that doctors who care for children these days have to be skilled, not just in the physical aspects, but also the psychosocial aspects of early childhood development.

Assembling the ideal foundational building blocks for the brain begins in the womb where we aim to nourish the brain of the fetus by asking the mom to eat healthy (consume proper amounts of DHA/omegas which have been linked to optimal brain development), to limit toxic stress, and to get proper antenatal care.

Toxic stress and adverse childhood events have been shown to negatively impact neural connections in the brain’s development — areas such as the hippocampus and the prefrontal cortex are very sensitive to adverse conditions. Downplay the critical importance of stress and the stage may be set for adverse outcomes.

It is indeed important to turn off electronics more often and to open books instead. The AAP and the Canadian Paediatric Society are very clear that excessive screen time must be discouraged by doctors. However, the competition between electronic screens and reading is won time and again by the magnetic, mesmerizing attraction of technology — regardless of policy statements by pediatricians.

Since I started to limit my clinical practice to children in 1983, I have never seen such an interest in the science of early and subsequent brain development as we see currently.

Optimal brain development is facilitated by proper sleep, reducing stress, reading for children, and engaging in play preferably outside in fresh air. This is old news. But being interested in mindfulness and also nutrition, I wonder if these two aspects are often neglected when it comes to helping families help their children to be ready for school.

I use the analogy of the brain being like a lawn. We have two options. One is to leave the lawn alone and hope for rain and zero weeds. Another option is to fertilize and water the lawn and pull out the weeds.

How we fuel the brain matters a great deal. Google the term “Brain Food” and one will see a plethora of resources. Sadly, many suggestions are not evidence-based, but how about starting with logical approaches — points of agreement — such as more fruits and vegetables and the use of DHA sources. To my knowledge, there is no paper comparing vegan children to those who follow a SAD program in terms of academic skills (Standard American Diet refers to a diet of unhealthy fats and excessive sugar and salt intakes).

Mindfulness as a tool to help a child be more resilient is still seen as “foreign and suspect” by some. Our culture asks for proper school lunches and mandates physical education, but the Swiss cheese hole is indeed lack of resilience training in schools, starting at an early age. Just like exercise benefits the brain, and thus got mandated, I would suggest that it is time to also help students be more resilient to adverse events by teaching mindfulness in schools.

A minority of children have temperaments which do not match the teaching style of the school. This creates stress, and regardless of how much Canadians pride themselves in an egalitarian health-care system, these unfortunate children continue to fall through the cracks, because their school-readiness is not properly addressed.

The role of parental depression and stress also impact a child’s brain development and socio-emotional readiness for schools. Pediatricians may look at kids, but we also ensure close collaboration with family doctors who can deal with parental depression.

In the old days, the majority of physicians focused on the physical aspects of school readiness. Times have changed. Mental wellness — or lack of it — seems to have become an almost biggest driver of determining school readiness. The AAP realizes this shift and is advocating for future pediatricians to be intentionally trained better to meet the needs of families. Academic skills alone are not the only focus anymore.

This Week's Flyers

Comments

Postmedia is pleased to bring you a new commenting experience. We are committed to maintaining a lively but civil forum for discussion and encourage all readers to share their views on our articles. Comments may take up to an hour for moderation before appearing on the site. We ask you to keep your comments relevant and respectful. Visit our Community Guidelines for more information.